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Reality Check: The Fat Won't Just Disappear

We've talked about the issue before: A significant percentage of children in the United States -- 35 percent according to national figures -- are obese. But who would have thought that their parents don't know it?

That's the crux of research out of the University of Michigan C.S. Mott Children's Hospital. The hospital's poll states that 15 percent of kids ages 6 to 11 are obese, as classified by their parent-reported height, weight and age, which was then calculated into their Body Mass Index. But 43 percent of their parents said their child was "about the right weight." Parent perception changed as their children aged. Of overweight kids ages 12-17 (they number 10 percent), many more of their parents classified them as "slightly overweight" (56 percent) and "very overweight" (31 percent).

"It suggests to me that parents of younger kids believe that their children will grow out of their obesity, or something will change at older ages," Dr. Matthew M. Davis, a University of Michigan professor of pediatrics and internal medicine who led the study told the Associated Press.

Do you agree? Do you think "chubby" kids will grow into their weight? What changes do we need to make to turn all our kids into a healthier generation?

By Stacey Garfinkle |  January 3, 2008; 9:45 AM ET  | Category:  Elementary Schoolers
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Comments


The problem with BMI is that it's too simplistic, and doesn't take into account the fact that muscle weighs much more than fat.

I remember taking a class once with a Marine Colonel who I swear had about 1 percent body fat. I mean this guy had about a 28-inch waist and muscles out the wazoo. But by the BMI he was listed as "obese". That's why the military services use measures of body fat, instead of BMI.

That may not be the case with too many kids, but it likely affects some. It's quite possible that a parent will report her child as being about right, or in good physical condition, while a simplistic BMI calculation will show the child as being overweight.

Posted by: ArmyBrat | January 3, 2008 9:53 AM | Report abuse

I think we need to relax....getting too upset over your kids weight will more likely cause them to develop an eating disorder. Just make sure they get enough fresh and exercise, and don't berate them about their weight.

Posted by: Me | January 3, 2008 10:17 AM | Report abuse

ArmyBrat, it likely affects close to zero kids. Why? Because males can only start developing such musculature after going through puberty. Perhaps there are a few 17 year olds who are that buff, but it's extremely unlikely.

Anyway, Stacey, did you notice the wide range of numbers you gave? 35% of kids are obese. 15% of 6-11 year olds are obese. 10% of 12-17 year olds are overweight. None of this makes any sense.

First off, "obese" and "overweight" mean different things. I'm not sure what the definitions are for kids, but "obese" for adults means a BMI over 30 while "overweight" means a BMI over 25. Is this the same for kids? If so, I doubt that 35% of kids are obese.

As for the major point of the post, I agree that many parents don't seem to understand that a little extra chub as a child can actually mean that their kids are overweight. Moreover, being overweight as a child appears to be connected to being overweight as an adult, though I'm not sure about the cause-and-effect relationship there. Nonetheless, it seems likely that healthy eating and exercise habits as a child will translate to healthier eating and exercise habits as an adult.

Posted by: Ryan | January 3, 2008 10:21 AM | Report abuse

I agree with Me. Make sure the get plenty of exercise and eat reasonably well and they'll be fine.

Posted by: Dennis | January 3, 2008 10:22 AM | Report abuse

The problem is "chubby" is not obese and can be normal as some kids grow out then up in growth spurts. I was considered a "chubby" kid, though I was not grossly overweight. I thought I was pretty normal and did grow up to be a slim adult, without getting wacky about diets and such. Many parents have similar experiences and thus discount their own child's weight too much. But these days, way too many kids are actually obese, and they are building lifestyle habits of eating fast food in front of the tube that will haunt them well into their adult lives.

Posted by: growing up and out | January 3, 2008 10:29 AM | Report abuse

As a chubby child who now is a fat adult, I wish my parents had been more proactive encouraging sports and better food choices. I started the cycle of dieting and then regaining weight in college. I wish that I had been encouraged better when I was young.

Posted by: discouraged | January 3, 2008 10:34 AM | Report abuse

I think this IS something to worry about... just spend time in a place where a large cross-section of the public gathers, like a mall, and you will see a lot of overweight kids. These kids are not only likely to have more health problems later in life, but may also suffer social problems with their peers. Overweight kids get teased, even though there are more of them.... this has been experienced by a young relative of mine. Unfortunately genetics often have a lot to do with it. But, I've also seen parents giving in to a child's picky eating early in life (child doesn't want the more healthful food offered, demands something less healthful, parent gives in to whining, crying, etc.) We all know that everyone is less active - there are fewer open spaces for children to safely roam, less sidewalks, more time in front of TV and computer, etc. etc. Gone are the days when mom could send a kid to the corner store for milk. Parents are less active too, and often have the same bad eating and behavior habits as the kid. There is not an easy fix, but caring parents have to change their OWN behavior first, set an example for both eating, physical activity, and TV/computer time, and then be firm with their children about these things. The rest of us can help by supporting walkable, safe communities - more sidewalks, mixed-use so that we CAN walk to the store, playground, park, school, etc., and supporting open space in our communities. We have to admit we have a problem before we can fix it.

Posted by: MH | January 3, 2008 10:43 AM | Report abuse

I just saw some add for BCBS that noted that most overweight adults think they're about "right" weight-wise. Is it any surprise parents think their kids are OK too?

Compared to everyday bodies, particularly those of the middle and lower classes, weight standards are pretty thin.

Everybody seems to know somebody who is heavier than they are, so they don't feel so overweight.

I think the most important thing a parent can do is set a good example. Let the kids see you brown bagging a turkey sandwich and snacking on an apple. Let them see you suiting up for a daily run/walk/workout. In the end they will copy what they see at home.

Posted by: RoseG | January 3, 2008 10:45 AM | Report abuse

According to a study by LSU, 13 million kids in the US suffer from malnutrition -- 30% of African American kids and 40% of Hispanic kids suffer from it. Now we have another 'study' showing kids are overweight and obese. Of course you can be obese and be malnurished at the same time. Are there any 'normal' kids in America? People put too much emphasis on body weight. As long as they are active and healthy, what's the fuss about? ANd take those damned annoying 'studies' with a grain of salt. Statistics can be manipulated -- DUH!

Posted by: Anonymous | January 3, 2008 10:53 AM | Report abuse

"As a chubby child who now is a fat adult, I wish my parents had been more proactive encouraging sports and better food choices"

As a skinny child who is now a fat adult, I wish my parents had been more proactive encouraging better eating habits. All the adults in my life encouraged me to eat more because I was too skinny. At age 40 there was a rude awakening that all those years of eating whatever I wanted whenever I wanted and not gaining wait were over.

Posted by: Anonymous | January 3, 2008 10:57 AM | Report abuse

As someone with a close relative in social services and who's heard her stories from the front lines, I think the study results are believable. But, I would also leaven the findings with the fact that many kids who end up as normally-weighted adults go through chubby phases. They fill out, then they shoot up. It's happened a lot in my family. The kids we should be worried about, though, are the ones who live with a remote or joystick in their hands on a diet of carryout or fast food. They're definitely out there.

Posted by: Mom | January 3, 2008 11:00 AM | Report abuse

Ryan, you may be right on relatively few children/teens being impacted by the fat vs muscle BMI issue; I haven't checked.

I did find the Center's for Disease Control's web page on BMI for Children and Teens. It's at http://www.cdc.gov/nccdphp/dnpa/bmi/childrens_BMI/about_childrens_BMI.htm

Ryan's right; none of the numbers being thrown around on this blog make any sense. According to the CDC website, BMI for children and teens is calculated as a percentile - it shows where you are relative to other children of the same age and sex.

For age and sex, the following table applies:
Underweight = Less than the 5th percentile
Healthy weight = 5th percentile to less than the 85th percentile
At risk of overweight = 85th to less than the 95th percentile
Overweight = Equal to or greater than the 95th percentile

(The term "obese" does not appear on the CDC web page.)

So if only the top 5 percent are "overweight", how can there be so many kids who are "overweight" and "obese" according to the U of Michigan? It seems like the Wolverines are using the Adult BMI calculations and applying them to kids - I'm not sure that's legitimate.

(I'm not saying that there aren't fat kids. I've coached softball, baseball, basketball and soccer over the past 12 years, and there are a LOT of fat kids out there! And yes, they need more exercise and less junk food. And yes, parents should set a good example.)

Posted by: ArmyBrat | January 3, 2008 11:03 AM | Report abuse

I suspect most parents have a better sense of things than the docs give them credit for. I'm sure there are some clueless parents out there. But the fact is, a lot of kids DO grow out of it -- it's called "baby fat" for a reason. My husband's family tends to have roly-poly babies who grow into normal-sized adults. His sister was a total butterball at 2, and is now as slim as can be. My niece takes after her -- lots of baby fat, but every year slimming up more and more.

I've seen the same thing in my son, who was a complete tubbo from birth -- as different from his skinny sister as you can imagine. I kept asking the doc if he was overweight, if I needed to watch his diet, start skim milk, etc. But the doc -- who has seen more babies than I can count -- kept telling me not to worry, that he was perfectly normal. And sure enough, as he has gotten older, he has started to grow into that belly. At 2, he's still big, but you can see that he's got shoulders and thigh muscles that match. He's never going to have the lanky build that my daughter does -- he's built just like his dad. Who, again, is not obese.

All this emphasis on weight is really destructive. You simply can't use epidemiological observations to predict what will happen to individual children in the future -- one BMI measurement on a kid at 2 or 5 or 12 says absolutely nothing about whether that child will grow up to be obese. And focusing on such an irrelevancy risks creating some really damaging weight fixations and habits. Focus on what matters: offer your kids a healthy variety of foods, and give them lots of time to run around outside and play themselves silly.

Posted by: Laura | January 3, 2008 11:03 AM | Report abuse

I see many of my children's friends drinking way too much juice as yonger kids, and then soda pop as pre-teens and teens. it is disconcerting to see children consuming so much sugar (I mean, in moderation, Fruit Loops are great, but c'mon).

Step one, healthy eating.

Step two, excercise, fresh air, etc. While an hour of soccer each Saturday is great, it needs to be balanced with bike riding, walking, free play etc. So much of what many of us had as children has disappeared because of changing social norms. I grew up in an urban environment and still had the "mom sends out out in the morning and we don't come home til dinner" experiences and all the neighborhood kids would play hoops, touch football etc, all unsupervised. It is sad we have lost that sponteneity, but still we need to figure out how to get kids out of the house and playing, running around etc. rather than watching TV, playing video games or surfing the net as primary forms of engagement.

Posted by: A Parent | January 3, 2008 11:09 AM | Report abuse

I have been dealing with this with my 8 year-old. We went to the Children's Fitness Clinic at UVA, learned some good things, but didn't really have to make too many changes. The downside is that my son now thinks of himself as "fat" and feels bad about himself - he didn't before we began the year with the program. I think we have to be so careful with all this - education about food choices and exercise are important! Let's start with school lunches being less carb & fructose!

Posted by: lck | January 3, 2008 11:31 AM | Report abuse

Why do parents "treat" their children to cake and ice cream and "force" them to eat fruits and vegetables?

Because they are child abusers with huge guilt feelings.

Look around, our children are fat, and an 11 year old does not have "baby" fat.

Posted by: a concerned parent | January 3, 2008 11:35 AM | Report abuse

ArmyBrat

"I remember taking a class once with a Marine Colonel who I swear had about 1 percent body fat. I mean this guy had about a 28-inch waist and muscles out the wazoo."

Allow me to hold the door as you step out of the closet...

Posted by: Anonymous | January 3, 2008 11:42 AM | Report abuse

As a child, I was put on many risky or questionable diets. I was first put on a diet as an infant - the pedi said my mother was overfeeding me. By age 9, I was hospitalized with kidney failure after being on the Atkins diet for a month. I had lost 10 pounds, which was almost 20% of my body weight. Are you getting a picture of what was happening here? Looking back at pictures, I was completely normal. I never would have qualified as overweight, much less obese. I did, however, have a genetic disorder that caused puberty to begin in earnest when I was 7. My family seemed to think, with the full approval of the pediatrician, that they could starve me back into childhood.

The emotional abuse that went along with this behavior was pretty overwhelming. I'm now an obese adult - I'd safely call it that, considering that I am 5 feet tall and weigh 170. I am active, eat well, and generally try to take care of myself. I have to take catabolic steroids, which make it extremely difficult to maintain an appropriate weight. But more importantly, my metabolism was destroyed, along with my self-esteem, when I was small.

Having absorbed the lesson that it was better to be dead than fat, two out of three of my younger sisters had severe eating disorders. Seeing the way that I was treated made them adopt horrible attitudes toward food, and also somehow made them see that their worth was tied to their appearance, and my parents' love could be withheld if they put on a pound too much.

I say this as a cautionary tale. Sure, there are parents out there who don't know how fat their kids are - I am sure you will find that many of them are very fat themselves. But there are also families out there who obsess about any little amount of pudge and give their small children the idea that any fat is evil and a sign of moral depravity. Added to the view that the rest of society seems to take, that fat is the worst thing any person can possibly be, and you have a recipe for a sad person.

I worry that another generation of girls is being enslaved to a stupid ideal, not that my daughter (who has lived her entire life below the 10% for weight, admittedly) might put on a few pounds.

Posted by: Been there | January 3, 2008 11:46 AM | Report abuse

I am a former gymnastics coach. You would be horrified how many parents brought their severely overweight kids to gymnastics classes believing that "the doctor told us she needed to lose weight and gymnasts are skinny so this should be perfect for her." These are children whose weight would break their neck if they did a basic headstand and whose arms cant hold them up in a cartwheel. I had a 95-lb SIX year old in one of my classes. The parents were deluded and torqued when their kids didnt lose the weight "from gymnastics" and the kid felt HORRIBLE watching all the other kids easily do things they couldnt. They did much better though after I convinced them that soccer would be easier and more beneficial (all that running around).

BTW-Fortuntely, I taught both the soccer and gymnastics teams.

Posted by: tunatofu | January 3, 2008 12:18 PM | Report abuse

Spend less time worrying about your child's weight and more time playing with them outside...or just spend more time with them, period.

Posted by: NoDisorder | January 3, 2008 12:57 PM | Report abuse

I will say though, as an obese 26-year-old who just went through major surgery (ruptured appendix), I would probably be dead if I had been slim. My appendix had ruptured a month ago, and my body absorbed most of the toxins. When it ruptured again a couple weeks ago (I didn't know what had happened the first time, and didn't go in), I had already dropped 24 lbs, and Im still losing 7 lbs a week as I heal. I have no appetite, and I wonder how someone with no weight to spare would have dealt with the loss.

Keep in mind, I have always had perfect cholesterol, blood sugar, and could dance for hours without getting winded before my appendix burst.

On the other hand, it is hard to watch parents enable their kids' overeating disorders because its cheaper than therapy, and somehow comforting to the parent to see their kid eating themselves to death.

Posted by: Kat | January 3, 2008 1:17 PM | Report abuse

Some people call it fat, others call it famine insurance!

Posted by: DandyLion | January 3, 2008 1:40 PM | Report abuse

"Chubby" isn't a terribly descriptive term, unfortunately, so it's sort of hard to answer the question. I think if the child is eating a healthy diet and has a good activity level, there isn't a whole lot you can do except let them have the body type they were designed for. Oh, and making sure they get enough sleep is very important, too- inadequate sleep has a stronger link to obesity than a sedintary lifestyle.

Posted by: reston, va | January 3, 2008 1:52 PM | Report abuse

Kids pick up eating habits at home and from their parents. If your kid is obese, it's most likely your fault. I saw a kid at a shopping mall who was so fat he was shiney; his mother was feeding him a load of french fries. A mother here brought her kids in to work (school was closed for some reason) and fed them pizza, french fries, and chocolate cake for lunch. Her 10-year-old daughter is obese now. Go figure.

Posted by: Take a look at yourself | January 3, 2008 1:55 PM | Report abuse

Honestly, the BMI measurement makes me crazy. My nine year old came home with a paper from school saying she was "at risk for obesity". She was crying and kept asking me if she was fat. She is very active, walks to school everyday (and back and forth for lunch), dances 6 hours a week and spends most afternoons running around outside with the neighborhood. She also eats well. I spoke with her about healthy eating and being active and how if she maintains these habits she will be the healthy size she is meant to be. The pediatrician reinforced this a few weeks later at her appointment. But I still find her looking in the mirror more and asking if her belly is a normal size. What little kid needs that pressure? I also called the school and was assured in the future such papers will be mailed to parents, not sent home with the kids. If kids are active and eat well they will be fine. They need to see parents doing the same thing.

Posted by: Momof5 | January 3, 2008 2:27 PM | Report abuse

I think it's more important to note the kids activity balance, food habits and genetics. That's going to be a lot bigger indicator of long term problem than being chubby before or during puberty.

Posted by: Liz D | January 3, 2008 2:38 PM | Report abuse

I was an inactive, depressed 10 year old and weighed 142 lbs. I was a happier 14 yr old who liked to skateboard and weighed 142lbs.- but according to the marks on my closet wall, I was about 6-8 inches taller. All the lines from age 10-14 are about the same weight, 140-142 lbs.

Now, I didn't learn healthy eating habits and after I turned 30 I gained serious weight that didn't come off, but yes Virginia, there is a chance that fat tweens will turn fat into muscle.

Posted by: Anonymous | January 3, 2008 2:56 PM | Report abuse

I should mention that you really have to take into account the individual in all these studies. I have two skinny kids because they don't like candy, never drink more than one glass of juice per day, love to eat fresh vegetables (I always make the vegetables perfectly so they always have good memories of vegetables- unlike my mother opening a can of succotash into the pot on the stove). But you know what else? they have the genetics for it too- I've seen their father in law eat 24 large ravioli at dinner and he's under 200 lbs- he's got diabetes from all the food, but he's under 200 lbs, he sits down all day, but he's under 200 lbs...

But the other thing was that my wife and I decided "no candy for Christmas." Grandparents had to bake the treats the kids got- we did too. They got some candy from friends at school, but everything else was a home-baked treat. How careful were we to make really special cookies if that was the only treat we did? Did Grandma make sure that both kids helped make cookies because those were only treats? yup. Did the mother in law make sure the kids helped with the pies? sure. Did the kids complain they didn't get M+Ms or lifesavers? No- they got cookies! Time will tell how it all works.

Posted by: Anonymous | January 3, 2008 3:08 PM | Report abuse

I'm with the general trend on the comments. I think in North America we do have both food and lifestyle issues that need to be addressed, especially living an active and healthy lifestyle. I know I fall down on the job sometimes and don't get outside with my son as often as I would like.

But I think it is worrying to start trying to address "obese children" without addressing the whole family's lifestyle - I think dieting in particular is destructive and I think shaming people rarely, if ever, works as a lifestyle-changing strategy. I'd much rather see effort go into setting up great family play areas/pick-up sports at a school than effort put into weighing everyone and sending a bunch of letters home.

Posted by: Shandra | January 3, 2008 3:23 PM | Report abuse

BMI is a quick, no-cost rule-of-thumb test you can do for yourself, and it holds true for most people--the body fat methods are more complicated. But the fat is real: If you look around any supermarket these days, you'll see eight-year-olds with their bellies hanging over the waistlines of their pants...ten-year-olds with treetrunk legs. Solid puffy cheeks, solid puffy arms, broad necks. And that's not the grossly overweight. Those are the "sorta normal" kids. Most look a lot like their parents, but not always--sometimes their parents are both thin. Thirty years ago, you might see one kid in a class of 25 looking like this. Now there are 5-8. It's not just a lower-middle class thing either. It's everyone.

I used to work at the National Heart, Lung, and Blood Institute and had access to a lot of large, well-controlled population studies. The upshot: those kids mostly won't outgrow it without making changes--fat tracks into teen age and adulthood, and it's getting worse. Pediatricians and nutrition experts all over the country are now seeing the diseases of middle age in preteens, for the first time in all of history. Type II diabetes, high blood pressure, high blood cholesterol, kidney stress, the works. However, the answer isn't to put the kid on a very restrictive or crash-type diet. If you do want your kids to "grow out of it", best practice guidelines now call for an hour a day of active exercise, substituting fresh fruits and vegetables and low-fat milk for extras like packaged snacks and sodas, and following a balanced, commonsense daily diet. (You know, all the things that used to be normal.) I recommend the DASH (Dietary Approaches to Stop Hypertension), which is well-tested, good for the whole family, and not hard to follow. You can find it at www.nhlbi.nih.gov.

Posted by: Concerned parent | January 3, 2008 3:29 PM | Report abuse

My kids are skinny so my concern is healthy eating. I don't obsess on it but I keep lots of healthy food and some amount of junk food. They both choose healthy more than junk but they're never deprived.

I don't see that many obese kids in our neighborhood and schools. Ours is a community that stresses activities -- sports, biking, swimming, skateboarding, hiking. There's something for everyone. The school encourages running and rewards the kids for reaching milestones.

People are always so quick to blame fast food and unhealthy snacks but it seems to me that it is a matter of activity more than food. When you're active you can eat pretty much whatever.

As to baby fat -- there's a kid on my dd's soccer team with a big gut. She runs as much and well as any of the others. I'm sure that once hormones kick in that she'll trim down. I am not comfortable with this one size fits all mentality. If the kids are active and eating well they'll turn out fine.

Posted by: free bird | January 3, 2008 4:04 PM | Report abuse

For the person who said: "When you're active you can eat pretty much whatever." Unfortunately, you really cannot eat 'whatever.' Even if someone is thin, poor eating habits can lead to high cholesterol, high blood pressure, and arterial plaque. All of these things are dangerous and can be quite expensive when they turn into emergencies and have to be treated in hospital emergency departments, not to mention the cost of a lifetime of diabetes, cholesterol, blood pressure drugs. Let's be honest with ourselves and our children; one must eat health AND remain active in order limit the risk of obesity and the health risks for which obesity is typically an indicator.

Posted by: health sciences student | January 3, 2008 4:15 PM | Report abuse

High cholesterol is as much a genetic thing as a diet thing. A married couple can eat the same food at 2 out of 3 meals a day and one will have high cholesterol and the other will be just fine. The illnesses you've been batting around all day are not all the result of poor diet. A predisposition to diabetes can be genetic, as well. So can heart disease. My grandparents lived into their 90's (93 and 97) and ate eggs fried in lard every morning and enough coffee to float a battleship. I never saw a salad served in their house. Yet a friend who is tall and thin has cholesterol in the 300+ range. While you're pointing fingers about obese children, why not discuss AIDS/HIV, which is 99% preventable. We've known for years how it is spread and it is still not wiped out.

Posted by: Anonymous | January 3, 2008 4:31 PM | Report abuse

I want to know who develops the charts the doctors use. My older daughter is so thin she needs slim sizes, yet her weight hits the 50th percentile. How can such a slim child be anywhere near the 50th percentile for weight? It has really made me question the "obesity epidemic." Do we really have a lot of fat kids, or do we have instead a lot of kids who are slightly plump (aka baby fat), but are technically classified as overweight? Obesity is, of course, a different story, but it is always lumped together with "overweight," which greatly increases the number of children involved.

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